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Diabetes mellitus, obesity, and hepatic steatosis.
Semin Gastrointest Dis. 2002 Jan; 13(1):17-30.SG

Abstract

Nonalcoholic fatty liver disease is emerging as the most common liver disease in North America. The histological spectrum of nonalcoholic fatty liver disease ranges from fatty liver alone to steatohepatitis and to the most serious form--nonalcoholic steatohepatitis (NASH). An increasing body of evidence suggests that NASH is associated with the development of progressive fibrosis and eventually cirrhosis in approximately 20% of cases. These data emphasize the need to develop effective therapy for the treatment of NASH. Cases occur most commonly in obese middle age women with diabetes. However, NASH may also occur in children and normal weight men with normal glucose and lipid metabolism. The pathophysiology involves 2 steps. The first is insulin resistance, which causes steatosis. The second is oxidative stress, which produces lipid peroxidation and activates inflammatory cytokines resulting in NASH. Liver biopsy provides prognostic information and identifies NASH patients who may benefit from therapy. Treatment consists of managing the comorbidities: obesity, diabetes, and hyperlipidemia. Nascent clinical trials suggest that a number of therapies may be beneficial. These include anti-oxidants such as vitamin E and betaine, bile acid therapy with ursodeoxycholic acid, and improved insulin sensitivity with metformin. Another potential therapeutic strategy is the reduction of inflammatory cytokines.

Authors+Show Affiliations

Division of Gastroenterology, Case Western Reserve University, Cleveland, OH, USA.No affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

11944630

Citation

Youssef, Wael, and Arthur J. McCullough. "Diabetes Mellitus, Obesity, and Hepatic Steatosis." Seminars in Gastrointestinal Disease, vol. 13, no. 1, 2002, pp. 17-30.
Youssef W, McCullough AJ. Diabetes mellitus, obesity, and hepatic steatosis. Semin Gastrointest Dis. 2002;13(1):17-30.
Youssef, W., & McCullough, A. J. (2002). Diabetes mellitus, obesity, and hepatic steatosis. Seminars in Gastrointestinal Disease, 13(1), 17-30.
Youssef W, McCullough AJ. Diabetes Mellitus, Obesity, and Hepatic Steatosis. Semin Gastrointest Dis. 2002;13(1):17-30. PubMed PMID: 11944630.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diabetes mellitus, obesity, and hepatic steatosis. AU - Youssef,Wael, AU - McCullough,Arthur J, PY - 2002/4/12/pubmed PY - 2002/10/31/medline PY - 2002/4/12/entrez SP - 17 EP - 30 JF - Seminars in gastrointestinal disease JO - Semin Gastrointest Dis VL - 13 IS - 1 N2 - Nonalcoholic fatty liver disease is emerging as the most common liver disease in North America. The histological spectrum of nonalcoholic fatty liver disease ranges from fatty liver alone to steatohepatitis and to the most serious form--nonalcoholic steatohepatitis (NASH). An increasing body of evidence suggests that NASH is associated with the development of progressive fibrosis and eventually cirrhosis in approximately 20% of cases. These data emphasize the need to develop effective therapy for the treatment of NASH. Cases occur most commonly in obese middle age women with diabetes. However, NASH may also occur in children and normal weight men with normal glucose and lipid metabolism. The pathophysiology involves 2 steps. The first is insulin resistance, which causes steatosis. The second is oxidative stress, which produces lipid peroxidation and activates inflammatory cytokines resulting in NASH. Liver biopsy provides prognostic information and identifies NASH patients who may benefit from therapy. Treatment consists of managing the comorbidities: obesity, diabetes, and hyperlipidemia. Nascent clinical trials suggest that a number of therapies may be beneficial. These include anti-oxidants such as vitamin E and betaine, bile acid therapy with ursodeoxycholic acid, and improved insulin sensitivity with metformin. Another potential therapeutic strategy is the reduction of inflammatory cytokines. SN - 1049-5118 UR - https://www.unboundmedicine.com/medline/citation/11944630/Diabetes_mellitus_obesity_and_hepatic_steatosis_ L2 - http://www.diseaseinfosearch.org/result/2236 DB - PRIME DP - Unbound Medicine ER -